Clinical Exploration of Transcatheter Closure of Patent Ductus Arteriosus With Duct Occluder in Infants

Objectives To explore the feasibility, necessity, and security of transcatheter closure of patent ductus arteriosus (PDA) in infants. Methods There were 230 infants with PDA. The ages were (7.3±3.2) months and the weight (6.6±2.8) Kg in average. They were separated into two groups. Group A was formed by the infants weighing less than 6 Kg, Group B over 6 Kg. Right heart catheterization was performed first to calculate the ratio of Qp/Qs. Then descending aortography demonstrated the diameter and shape of PDA. Proper occluder was selected to finish the intervention. Echocardiography was performed after intervention 24 hours and 1, 3, 6, 12 and 24 months. Results In Group A the technical achievement ratio was 94.6% with the average diameter of PDA (6.2±3.2) mm. In Group B the technical achievement ratio was 100% with the average diameter of PDA (4.8±2.5) mm. We used the Amplatzer Duct Occluder with the type from 6-8 mm to 12-14 mm, the delivery sheath from 6 French to 8 French. 24 hours after intervention, echocardiography demonstrated that there were 6 residual shunts in Group A while 22 in Group B. After 1 year, residual shunt existed in neither group. There were 4 patients whose femoral arteries pulsed weakly after intervention in Group A, while in Group B there were 3. They all recovered 24 hours after the application of urokinase. In Group A blood flow velocity in descending aorta increased in 5 infants, while in Group B there were 3. They all resumed in 6-12 months. Conclusions Transcatheter closure of PDA in infants is safe and technically feasible. However, indication should be strictly selected and the intervention should be performed by experienced physician.